May is National Stroke Awareness Month — no better time to address the aftermath of a stroke, its symptoms and treatments. Many of our hospice care patients are stroke victims in San Francisco and elsewhere, so we hope this information proves helpful for both stroke patients and their families.
Stroke is a disease that affects the arteries leading to the brain and within it. Basically, a stroke occurs when a blood vessel that is bringing oxygen and nutrients to the brain is blocked by a clot or ruptures. When this occurs, part of the brain is not able to get the blood and thus oxygen it needs, which leads to brain cell death. Stroke happens to be the fifth cause of death and leading cause of disability in the United States, according to the American Stroke Association. The good news is that 80 percent of strokes are preventable.
Stroke in Hospice
Unfortunately, strokes can lead to the need for hospice care. Determining whether someone is appropriate for hospice care following a stroke will depend on the severity of its effects, says Very Well Health.
Acute Stroke: Just like with any injury to the neurological system, strokes take time to manifest their full effect. A stroke victim is usually granted sufficient time to start the recovery process before a conclusive prognosis is reached. Typically, when no improvement is found in neurological functioning after about three days, the likelihood for a full recovery is not very positive. Criteria for a sudden, or acute, stroke show that the victim must have one of the following conditions for three days at least:
- Coma
- Vegetative state
- Severely-reduced consciousness level, with abnormal muscle contraction
After the first three days, other considerations will assist in determining the person’s life expectancy and whether hospice is an appropriate course of action. Factors include abnormal neurological response, such as when the patient doesn’t respond to painful stimuli. Increased age also affects outcome as well, with people over the age of 70 years old having an increased likelihood of death from stroke.
Symptom Management: Hospice care for an acute stroke will focus on symptom management. Symptoms requiring treatment are diverse. Immobility and other diseases can bring on pain as an involuntary muscle contracts or spasms in relation to neurological damage, for example. Aspiration pneumonia often results in nausea and vomiting, and constipation can be caused by anything from medications to eating certain foods. Additionally, sores on the skin due to immobility are uncomfortable and painful. There’s also anxiety, restlessness, and depression to contend with. Accessing hospice care as soon as it is appropriate will ensure symptoms are properly managed, and can help prepare both the patient and family members for the road ahead. This is where compassionate hospice care teams come in.
Effects of Stroke
The brain is a very complex organ responsible for controlling a variety of bodily functions. If blood flow can’t reach the region that controls a specific body function, that part of the body will not operate as it should. For instance, if the stroke occurs in the back of the brain, some type of vision loss will result. The effects of a stroke will depend largely on the obstruction’s location and how much brain tissue was affected. But because one side of the brain controls the opposite side of your body, a stroke affecting one side will manifest in neurological issues on the side of the body it impacts.
Left Brain
When a stroke occurs on the left side of the brain, the right side of the body is affected. Symptoms include:
- Paralysis on the right side of the body
- Speech and/or language problems
- Slow and cautious behavioral style
- Memory loss
Right Brain
When a stroke occurs in the right side of the brain, the left side of the body is affected. Symptoms include:
- Paralysis on the left side of the body
- Vision complications
- Quick, inquisitive behavioral style
- Memory loss
Brain Stem
When a stroke occurs within the brain stem, it may affect both sides of the body, depending on how severe the injury. It can also leave the victim in a “locked-in” state, meaning they are unable to speak or move anything below the neck.
There are no doubt many physical, communication, emotional and behavioral complications that can arise as the result of a stroke. Through awareness and symptom treatment, these can be alleviated somewhat. The statistics are grim. One in four stroke survivors has another. However, many strokes can be prevented by choosing not to smoke, making healthy dietary choices, getting plenty of physical activity, maintaining a healthy weight and promptly treating conditions such as high blood sugar, high blood pressure and high cholesterol.
Contact Pathways Home Health and Hospice
Here at Pathways, we welcome many stroke patients into our hospice care program. Contact us today to learn more about our process, services and more.
